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- All Subjects: public health
- Creators: Hruschka, Daniel
Exploring factors influencing Chinese American older adults' intentions to plan for end-of-life care
The current investigation seeks to longitudinally explore the antecedents to college students’ affirmative sexual consent behaviors (i.e., nonverbal, initiating, verbal). Using the Theory of Planned Behavior (TPB) as a theoretical framework, hypotheses predicted that at Time 1 (T1) attitudes, norms, and perceived behavioral control would positively and significantly predict students’ (T1) intentions to communicate affirmative consent to their partner. Then, it was predicted that at Time 2 (T2)—thirty days later—intentions to communicate consent from T1 would positively and significantly predict college students’ communication of affirmative consent to their partner during their most recent sexual encounter. The final matched (i.e., completed T1 and T2 surveys) sample included two hundred twenty-five (N = 225) college students who had engaged in sexual activity during the 30 days between survey distributions. Results from the path analyses support the theoretically driven hypotheses for all three affirmative consent behaviors, and demonstrate that subjective norms and perceived control are important and strong determinants of students’ communication of affirmative sexual consent. Furthermore, multi-group invariance tested the potential moderating effects of three individual, two dyadic, and two environmental/contextual variables on the strength of path coefficients between TPB constructs for all three sexual consent behaviors. Only individual and environmental/contextual variables significantly moderated relationships within the TPB for the three models. Results are discussed with regard to theoretical implications as well as practical implications for university health educators and other health professionals. Additionally, limitations and future directions are noted.
Methods: Parents of children six months to five years old (N = 975) were randomly exposed to one of four high-threat/high-efficacy messages (narrative, statistical, combined, control) and completed a follow-up survey. Differences between message conditions were assessed with one-way ANOVAs, and binary logistic regressions were used to show how constructs predicted intentions.
Results: There were no significant differences in the ANOVA results at p = .05 for EPPM variables or risk EPPM variables. There was a significant difference between message conditions for perceived manipulation (p = 0.026), authority, (p = 0.024), character (p = 0.037), attention (p < .000), and emotion (p < .000). The EPPM model and perceptions of message model (positively), and the risk EPPM model and fear control model (negatively), predicted intentions to vaccinate. Significant predictor variables in each model at p < .05 were severity (aOR = 1.83), response efficacy (aOR = 4.33), risk susceptibility (aOR = 0.53), risk fear (aOR = 0.74), issue derogation (aOR = 0.63), perceived manipulation (aOR = 0.64), character (aOR = 2.00), and personal relevance (aOR = 1.88). In a multivariate model of the significant predictors, only response efficacy significantly predicted intentions to vaccinate (aOR = 3.43). Compared to the control, none of the experimental messages significantly predicted intentions to vaccinate. The narrative and combined conditions significantly predicted intentions to search online (aOR = 2.37), and the combined condition significantly predicted intentions to talk to family/friends (aOR = 2.66).
Conclusions: The EPPM may not be effective in context of a two-way threat. Additional constructs that may be useful in the EPPM model are perceptions of the message and fear control variables. One-shot flu vaccine messages will be unlikely to directly influence vaccination rates; however they may increase information-seeking behavior. The impact of seeking more information on vaccination uptake requires further research. Flu vaccine messages should be presented in combined form. Future studies should focus on strategies to increase perceptions of the effectiveness of the flu vaccine.
Significant health inequalities exist between different castes and ethnic communities in India, and identifying the roots of these inequalities is of interest to public health research and policy. Research on caste-based health inequalities in India has historically focused on general, government-defined categories, such as “Scheduled Castes,” “Scheduled Tribes,” and “Other Backward Classes.” This method obscures the diversity of experiences, indicators of well-being, and health outcomes between castes, tribes, and other communities in the “scheduled” category. This study analyzes data on 699,686 women from 4,260 castes, tribes and communities in the 2015-2016 Demographic and Health Survey of India to: (1) examine the diversity within and overlap between general, government-defined community categories in both wealth, infant mortality, and education, and (2) analyze how infant mortality is related to community category membership and socioeconomic status (measured using highest level of education and household wealth). While there are significant differences between general, government-defined community categories (e.g., scheduled caste, backward class) in both wealth and infant mortality, the vast majority of variation between communities occurs within these categories. Moreover, when other socioeconomic factors like wealth and education are taken into account, the difference between general, government-defined categories reduces or disappears. These findings suggest that focusing on measures of education and wealth at the household level, rather than general caste categories, may more accurately target those individuals and households most at risk for poor health outcomes. Further research is needed to explain the mechanisms by which discrimination affects health in these populations, and to identify sources of resilience, which may inform more effective policies.